FORM 1

FORMATE FOR PARTICULARS OF THE COLLEGE/INSTITUTE FOR THE EXISTING

MEDICAL COLLEGE/PROPOSED TO ESTABLISH NEW MEDICAL COLLEGE/PROPOSED
TO INCREASE THE SEATS
1

NAME OF THE APPLICANT

Surat Municipal Corporation

(STATE GOVERNMENT./UNION

Name of the college:

TERRITORY/UNIVERSITY/ SOCIETY

Surat Municipal Institute of Medical

/TRUST)

Education & Research (SMIMER-)

ADDRESS

Surat Municipal Institute of Medical

NO., STREET, CITY, PIN CODE,

Education & Research (SMIMER)

Opp. Bombay Market, Umarwada,
Surat-395 010. Gujarat (India)
TELEPHONE NOS.

Phone No: 091-261- 2368040 to 43;

FAX NO.

FAX No: 091-261- 2343241

Surat Municipal Corporation

ADDRESS OF REGISTERED OFFICE

NO., STREET, CITY, PIN CODE,

Muglisara Daria Mahal,

Surat 395003
0261-2423751 to 56 & 2422285 to 87

TELEPHONE NOS.

0261- 2451935 &2422110

FAX NO.

CONSTITUTION

Surat Municipal Corporation

(STATE GOVERNMENT/UNION

(Local self government-Autonomous Body)

TERRITORY / UNIVERSITY
AUTONOMOUS BODY, SOCIETY, TRUST)
5

REGISTRATION/INCORPORATION

Not Applicable To Surat Municipal

(NUMBER AND DATE)

Corporation

NAME OF AFFILIATING UNIVERSITY:

Veer Narmad South Gujarat University,

(VNSGU), Surat

CATEGORY OF APPLICANT

Surat Municipal Corporation

(STATE GOVERNMENT/UNION TERRITORY/

(Local self government autonomous body)

UNIVERSITY /SOCIETY /TRUST)

BASIC INFRASTRUCTURAL FACILITIES

Annexure-I

AVAILABLE FOR MEDICAL COLLEGE AND

ATTACHED HOSPITAL (PLEASE ADD A SEPARATE
SHEET IF NECESSARY)

MANAGERIAL CAPABILITY:- Composition of the Society /Trust Particulars of Members of the

Society/Trust, Head or Project Director of the Proposed Medical College, Head of the Existing Hospital
Their Qualification and Experience in the Field of Medical Education.

Item

College

Dean

Medical
Superintendent

Name

Address

Surat Municipal Institute of

Dr. Kalpana

Dr. Vandana Desai

Medical Education &

A Desai

MD (Paediatrics)

Research

MD (Anesthesia)

Umarwada,

SMIMER,

SMIMER,

Near Bombay Market, Surat

Umarwada, Near

Umarwada, Near

Bombay Market, Surat

Bombay Market, Surat

State

Gujarat

Gujarat

Gujarat

Pin Code

395010

395010

395010

0261-2368040-42

0261-2366367 (Direct)

0261-2368040-43

Phone

Office

(EPBX)

Ext 1600

Res

--

0261-2252858

0261-2236849

Fax

0261-2343241

0261-2343241

0261-2360306

Mobile

09724345012

09724345013

E-mail

10

deansmimer@ gmail.com

deansmimer@

vmdesai@

gmail.com

rediffmail.com

FINANCIAL CAPABILITY
Balance sheet for the last 3 years to be provided if the

Owned and completely Financed by Surat

Municipal Corporation
Please refer Annexure- VI

applicant is a society / trust.

2

PART II
11

NAME AND ADDRESS OF THE EXISTING

MEDICAL COLLEGE

12

MARKET SURVEY AND ENVIRONMENTAL

ANALYSIS
a) Give the main features of the state medical
education policy.
b) Availability of trained medical manpower in the
state and need for increase in the provision of
medical manpower
c) Gap analysis and how the gap will be reduced.
d) Catchment area in terms of patients for the
proposed medical College / hospital.
e) No. of hospitals/primary health centres/private
clinics available in the Catchment area.

Surat Municipal Institute of Medical

Education and Research (SMIMER)
Opp. Bombay Market, Umarwada,
Surat - 395 010 (Guj)-India.

SMIMER medical college is in existence

since 2000-2001

f) State how will the existing medical facilities get

augmented by the establishment of proposed
medical college.
13

Merging of new areas & surrounding villages

into the Municipal Corporation

SITE CHARACTERISTICS AND AVAILABILITY OF EXTERNAL LINKAGES.

Please refer Annexure- III
(Master plan of the Medical College
Complex)

a) Topography

b) Plot size

T.P.S. NO. / F.P. NO.

Area in Sq. mtrs.

T.P.S NO. 8/ F.P. NO. 64

T.P.S NO. 8/ F.P. NO. 64

108472.00
30728.00

R.S. NO. / F.P. NO.

R.S. NO. 125 Paikee + 127/F.P.
No. 30/A & 30/B, etc
c) Permissible floor space index
d) Ground coverage
e) Building height

92719.00
As per GDCR norms of State Govt.
As per GDCR norms of State Govt.
College: A, B, C blocks (Academic blocks
with 3 floors each)
Administrative block with two floors
Hospital: G+6 floors
Medical College is in the center of the city
and easily approachable to general public
with well road connectivity.
Approachable with all modes of
transportation
Round the clock facilities are available.

f) Road access

g) Availability of public transport

h) Electric supply

i) Water supply

Continuous round the clock water supply is

ensured.
Yes
Yes

j) Sewage connection
k) Communication facilities
14

EDUCATIONAL PROGRAMME
a) Proposed annual intake of students

Recognized Seats
100
Permitted for additional seats 50
Please see the Annexure XIII

b) Admission criteria

Combined Std. 12 and GUJCET marks as per

MCI norms
In case of NRI seats as per MCI norms
Please see the Annexure XIV

c) Method of admission

Centralized admission criteria as laid down by

Govt. of Gujarat & MCI.
As per Govt. norms: Local quota: 70, All

d) Reservation/preferential allocation of seats:

Gujarat quota: 57 seats it includes reservation

for 15 % ST, 7 % SC, 27% OBCs)
( NRI: 15 % (23 seats)
Department wise and year wise curriculum of studies. - South Gujarat University, Surat has
adopted revised regulations of undergraduate medical education as prescribed by Medical
council of India.

Names of Subjects

Duration of study

First M.B.B.S.

Anatomy,
Physiology,
Biochemistry

One year
(1 st & 2nd semesters)

Second M.B.B.S.

Pathology
Pharmacology
Forensic Medicine
Microbiology

One and half year

(3 rd , 4th & 5th semesters)

Final M.B.B.S.

Part-I

ENT
Ophthalmology,
Community Medicine

(6th & 7 th semesters)

Part-II

Medicine (Including
Paediatrics)
Surgery (Including
Orthopedics)
Obstetrics & Gynecology

(8th & 9 th Semesters)

15 FUNCTIONAL PROGRAMME
Department wise
requirements

&

service

wise

functional
As per MCI recommendations

Area distribution and room wise sitting capacity

16 EQUIPMENT PROGRAMME:
Room wise list of Equipments complete with year
wise schedule of quantities and specifications
(a) Medical (b) Scientific (c) Allied Equipments

As per MCI recommendations

Please see Annexure I C

17 MAN POWER PROGRAMME

Department wise and year wise requirements of
(a) Teaching staff (full time)
As per MCI recommendations

(b) Technical staff

Please see Annexure I D

(c) Administrative staff

(d) Ancillary staff
(e) Salary structure

As per SMC resolutions (Annexure- XV)

(f) Recruitment procedure

By publishing the advertisement.

Selection through recruitment committee and
through DPC constituted by University as per
MCI norms / SMC rules & regulations.

(g) Recruitment calendar

As and when required.

18 BUILDING PROGRAMME
Building wise built up area of
(a) Medical college (departments, lecture theatre,
museum etc.)

Medical college: 19179.67 Sq.mts

(b) Examination hall

398.40 Sq.mts

(c) Faculty and staff housing

Teaching staff 5840.72 Sq.mts

(Kindly refer Annexure 1A)

Nursing & Paramedical staff 7037.66 Sq.mts

(d) Staff and students hostels

14396.42 Sq.mts

(e) Administrative office

College : 1348.45 Sq.mts

Hospital : 632.48 Sq.mts

(f) Library
(g) Auditorium

2347 sq.mts
Surat Municipal Corporation Auditorium is of
1200 capacity, available for use for SMIMER.

(h) Animal house

142 Sq.mt

(i) Mortuary

402.53 Sq.mts

(j) Cultural and recreational centre

Available in the campus

(k) Sport complex

10067.21 Sq.mts

(l) Others (state name of the facility)

--

19 PLANNING AND LAYOUT

(a) Master plan of the medical college complex

For copy of master layout plan

(b) Layout plans, sections

(c) Elevations and floor wise area calculations of the
5

Kindly refer Annexure III

medical colleges and ancillary buildings.

20 PHASING AND SCHEDULING

Month wise schedule of activities indicating
(a) Commencement & completion of building design
(b) Local body approvals
COMPLETED

(c) Civil construction

(d) Provision of engineering services and equipment
(e) Requirement of staff
(f) Phasing of commissioning

21 PROJECT COST
a)
b)
c)
d)
e)
f)

Capital cost of land

Buildings
Plant and machinery
Medical, scientific and allied equipment
Furniture and fixtures
Preliminary and preoperative expenses

100% funded by the Surat Municipal Corporation

The entire project cost is incurred by Surat

Municipal Corporation.

22 MEANS OF FINANCING THE PROJECT

(a)
(b)
(c)
(d)
(e)
(f)

-------

Contribution of the applicant

Grants
Donations
Equity
Term loans
Other sources (if any)

23 REVENUE ASSUMPTIONS
(a) Fee structure
(b) Estimated annual revenue from various sources

Please see Annexure - XVII

Please see Annexure - XVIII

24 EXPENDITURE ASSUMPTIONS
(a) Operating expenses
(b) Depreciation

Rs. 6.31 cr.

25 OPERATING RESULTS
(a) Income statement
(b) Cash flow statement
Kindly refer Annexure - VI
(c) Projected balance sheets
NOTE - For Items 14 to 18 a comparative statement showing the relevant Medical Council of India norms vis-vis infrastructure/faculty available and/or proposed to be made available should be annexed.

PART III
26

NAME AND ADDRESS OF THE

Surat Municipal Institute of Medical

EXISTING HOSPITAL

Education and Research (SMIMER)

Opp. Bombay Market, Umarwada,
Surat - 395 010 (Gujarat)-India.

27

DETAILS OF THE EXISTING HOSPITAL INCLUDING

686

a) Bed strength ( Total teaching beds)

b) Bed distribution, bed occupancy and
whether a norm of 5 in patients per student

Yes

would be fulfilled.
a)

Medicine & Allied Specialties

1)
2)
3)

General Medicine
Pediatrics
Tuberculosis & Respiratory Disease

4)
5)

Dermatology, Venerology & Leprosy

Psychiatry
Total
Surgery & Allied Specialties

b)

1)
2)
3)
4)

Gen. Surgery including Paediatrics

Surgery
Orthopaedics
Ophthalmology
Oto-rhino-laryngology

c)

Total
Obstetrics & ANC Gynecology

1)

Number of
Teaching
Beds

Number
of Units

150
90
30

05
03
01

13
13
296
Number of
Teaching
Beds

01
01
11
Number
of Units

150

05

45.11 %
64.68%
23.86 %
30.87%
65.24 %
Average bed
occupancy/ day
(% of Teaching beds)
(Apr 09(Apr 10Mar 10)
Oct10)
84.74 %
77.62%

90
30
30

03
01
01

86.14 %
39.07 %
56.90 %

300
Number of
Teaching
Beds

10
Number
of Units

90
686

03
24

Obstetrics & Gynecology

Grand Total
7

Average bed
occupancy/ day
(% of Teaching beds)
(Apr 09(Apr 10Mar 10)
Oct10)
85.60 %
103.43%
126.01%
105.05%
45.60 %
68.85%

68.79%
37.38%
90.32%

66.71 %
Average bed
occupancy/ day
(% of Teaching beds)
(Apr 09(Apr 10Mar 10)
Oct 10)
86.95 %
79.08%
72.97 %

c) Built up area

44115 sq.mt (Annexure I B)

d) Clinical and Para-clinical disciplines

(Annexure I A)

e) OPDs and IPD attendance department wise

Annexure II

f) Architectural and layout plans

Annexure III

g) List of medical/allied equipments

Annexure - IC

h) Capacity and configuration of engineering

services

Available

i) Hospital services, administrative services,

Annexure - IB

other ancillary and support services

(category wise staff strength)

Up-gradation And Expansion Programme:

Structural and function capacity of Surat Municipal Institute of Medical Education & Research, is for 150
undergraduate seats and hospital capacity is 750 beds so there is no need to upgrade or expansion of
college or hospital building in short coming days.

28

29
30

DETAILS ABOUT THE ADDITIONAL LAND FOR EXPANSION OF THE EXISTING

HOSPITAL
a) Land particulars
b) Distance from the proposed medical
college
c) Plot size
d) Authorized land usage
e) Geography
f) Soil condition
g) Road access
h) Availability of public transport
i) Electric supply
j) Water supply
k) Sewage connection
l) Communication facilities
UPGRADED MEDICAL PROGRAMME :- Year wise details of the additional clinical &
Para clinical disciplines envisaged under the expansion programme
UPGRADED FUNCTIONAL
PROGRAMME
a) Specialty wise and service wise
functional requirements
b) Area distribution
c) Specialty wise bed distribution

31

BUILDING EXPANSION PROGRAMME: Year wise additional built-up area to be provided

for
a) Hospital
b) Staff housing
c) Staff and students hostels
d) Other ancillary buildings

32

PLANNING AND LAYOUT: Upgraded master plan of the hospital complex along with
a) Layout plans
b) Sections
c) Elevations
d) Floor wise area calculation of the
hospital
e) Floor wise area calculation of
ancillary buildings

33

DETAILS ABOUT UPGRADATION OR ADDITION IN THE CAPACITY AND

CONFIGURATION OF ENGINEERING SERVICES AND HOSPITAL SERVICES

34

EQUIPMENT PROGRAMME Upgraded room wise list of

a) Medical and allied equipments
b) Schedule of quantities
c) Specifications

35

UPGRADED MANPOWER PROGRAMME Category wise distribution of

a) Medical staff
b) Para-medical staff
c) Other staff

36

PHASING AND SCHEDULING OF THE EXPANSION OF SCHEME Month wise schedule of

activities indicating
a) Commencement and completion of
building design
b) Local body approvals
c) Civil construction
d) Provision of engineering & hosp. services
e) Provision of medical & allied equipment
f) Recruitment of staff

10

37

PROJECT COST OF THE EXPANSION SCHEME- Cost of additional

a) Land
b) Buildings
c) Engineering services
d) Hospital services
e) Medical and allied equipments
f) Furniture and fixtures
g) Preliminary and pre-operative expenses
38

MEANS OF FINANCING THE PROJECT

a) Contribution of the applicant

b) Grants
c) Donations
d) Equity
e) Term loans
f) Other sources, if any
39

REVENUE ASSUMPTIONS: Income from

a) Various procedures and services

b) Upgraded service loads
c) Other sources
40

EXPENDITURE ASSUMPTIONS

a) Operating expenses
b) Financial expenses
c) Depreciation
41

OPERATING RESULTS

a) Income statements
b) Cash flow statements
c) Balance sheet

(Signature of Applicant)

11

SURAT MUNICIPAL INSTITUTE OF MEDICAL EDUCATION &

RESEARCH (SMIMER), SURAT
LIST OF ANNEXURES ATTACHED
ANNEXURE- I

BASIC INFRASTRUCTURAL FACILITIES AVAILABLE FOR MEDICAL COLLEGE AND

ATTACHED HOSPITAL

ANNEXURE- I A

EXISTING INFRASTRUCTURE AT MEDICAL COLLEGE SMIMER, SURAT

ANNEXURE- I B

EXISTING INFRASTRUCTURE AT SMIMER HOSPITAL, SURAT

ANNEXURE- I C

LIST OF INSTRUMENT / EQUIPMENTS

ANNEXURE- I D
ANNEXURE- II

DEPARTMENT WISE AND YEAR WISE REQUIREMENTS OF TEACHING STAFF ,

TECHNICAL STAFF, ADMINISTRATIVE STAFF & ANCILLARY STAFF
OPDS AND OPD ATTENDANCE DEPARTMENT WISE

ANNEXURE- III

MASTER PLAN OF THE MEDICAL COLLEGE COMPLEX

ANNEXURE- IV

COPY OF BYE LAWS / MEMORANDUM AND ARTICLES OF ASSOCIATION / TRUST

(ENCLOSURE-1)

DEED

ANNEXURE- V

COPY OF CERTIFICATE OF REGISTRATION/INCORPORATION.

(ENCLOSURE-II)
ANNEXURE- VI

ANNUAL REPORTS AND AUDITED BALANCE SHEETS FOR THE LAST THREE YEARS

(ENCLOSURE-III)
ANNEXURE- VII
(ENCLOSURE-IV)

COPY OF THE TITLE DEEDS OF THE TOTAL AVAILABLE LAND AS PROOF OF

ANNEXURE- VIII
(ENCLOSURE-V)
ANNEXURE- IX
(ENCLOSURE-VI)
ANNEXURE- X
(ENCLOSURE-VII)
ANNEXURE- XI

COPY OF ZONING PLANS OF THE AVAILABLE SITES INDICATING THEIR LAND USE

(ENCLOSURE-VIII)
ANNEXURE- XII
(ENCLOSURE-IX)

ANNEXURE-XIII
ANNEXURE- XIV

OWNERSHIP.

PROOF OF OWNERSHIP OF EXISTING HOSPITAL

CERTIFIED COPY OF THE ESSENTIALITY CERTIFICATE ISSUED BY THE
RESPECTIVE STATE GOVERNMENT/UNION TERRITORY ADMINISTRATION.
CERTIFIED COPY OF THE CONSENT OF AFFILIATION ISSUED BY A RECOGNISED
UNIVERSITY.
AUTHORIZATION LETTER ADDRESSED TO THE BANKERS OF THE APPLICANT
AUTHORIZING THE CENTRAL GOVERNMENT./MEDICAL COUNCIL OF INDIA TO
MAKE INDEPENDENT ENQUIRIES REGARDING THE FINANCIAL TRACK RECORD OF
THE APPLICANT.
PROPOSED ANNUAL INTAKE OF STUDENTS

ANNEXURE- XV

ADMISSION CRITERIA , METHOD OF ADMISSION & RESERVATION/PREFERENTIAL

ALLOCATION OF SEATS
SALARY STRUCTURE

ANNEXURE- XVI

PROJECT COST

ANNEXURE- XVII

FEE STRUCTURE

ANNEXURE- XVIII

ESTIMATED ANNUAL REVENUE FROM VARIOUS SOURCES

12

Form II
Essentiality Certificate; Permanent Affiliation by Government of Gujarat

13

Essentiality Certificate; Permanent Affiliation by Government of Gujarat

14

Essentiality Certificate; Permanent Affiliation by Government of Gujarat

15

FORM III

Essentiality Certificate; Permanent Affiliation by VNSG University, Surat

16

Essentiality Certificate; Permanent Affiliation by VNSG University, Surat

17

FORM IV
Undergraduate Degrees Recognition for 100 seats by Govt. of India
Letter No.U.12012/ 34/99-ME (P-II) Dated 1st July 2005

18

19